| NPI | 1225602311 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ LSAT-15151) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ 3088) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY 20104) | |
| Enumeration Date | 2021-05-13 |
| Last Update Date | 2021-05-13 |